TY - JOUR
T1 - Etiology of the Protein-Energy Wasting Syndrome in Chronic Kidney Disease
T2 - A Consensus Statement From the International Society of Renal Nutrition and Metabolism (ISRNM)
AU - Carrero, Juan Jesús
AU - Stenvinkel, Peter
AU - Cuppari, Lilian
AU - Ikizler, T. Alp
AU - Kalantar-Zadeh, Kamyar
AU - Kaysen, George
AU - Mitch, William E.
AU - Price, S. Russ
AU - Wanner, Christoph
AU - Wang, Angela Y M
AU - Ter Wee, Pieter
AU - Franch, Harold A.
PY - 2013/3
Y1 - 2013/3
N2 - Protein-energy wasting (PEW), a term proposed by the International Society of Renal Nutrition and Metabolism (ISRNM), refers to the multiple nutritional and catabolic alterations that occur in chronic kidney disease (CKD) and associate with morbidity and mortality. To increase awareness, identify research needs, and provide the basis for future work to understand therapies and consequences of PEW, ISRNM provides this consensus statement of current knowledge on the etiology of PEW syndrome in CKD. Although insufficient food intake (true undernutrition) due to poor appetite and dietary restrictions contribute, other highly prevalent factors are required for the full syndrome to develop. These include uremia-induced alterations such as increased energy expenditure, persistent inflammation, acidosis, and multiple endocrine disorders that render a state of hypermetabolism leading to excess catabolism of muscle and fat. In addition, comorbid conditions associated with CKD, poor physical activity, frailty, and the dialysis procedure per se further contribute to PEW.
AB - Protein-energy wasting (PEW), a term proposed by the International Society of Renal Nutrition and Metabolism (ISRNM), refers to the multiple nutritional and catabolic alterations that occur in chronic kidney disease (CKD) and associate with morbidity and mortality. To increase awareness, identify research needs, and provide the basis for future work to understand therapies and consequences of PEW, ISRNM provides this consensus statement of current knowledge on the etiology of PEW syndrome in CKD. Although insufficient food intake (true undernutrition) due to poor appetite and dietary restrictions contribute, other highly prevalent factors are required for the full syndrome to develop. These include uremia-induced alterations such as increased energy expenditure, persistent inflammation, acidosis, and multiple endocrine disorders that render a state of hypermetabolism leading to excess catabolism of muscle and fat. In addition, comorbid conditions associated with CKD, poor physical activity, frailty, and the dialysis procedure per se further contribute to PEW.
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U2 - 10.1053/j.jrn.2013.01.001
DO - 10.1053/j.jrn.2013.01.001
M3 - Article
C2 - 23428357
AN - SCOPUS:84874244749
VL - 23
SP - 77
EP - 90
JO - Journal of Renal Nutrition
JF - Journal of Renal Nutrition
SN - 1051-2276
IS - 2
ER -